ED Toolkit for Opioid Use Disorder
The goal of the META:PHI ED Toolkit for Opioid Use Disorder is to provide the resources necessary for a prescriber in any emergency department in Ontario to initiate buprenorphine when appropriate, along with additional materials to support all ED staff in providing evidence-based care for patients with opioid use disorder.
This toolkit was inspired by the CA Bridge program.
Prescriber information
This flowchart provides an algorithm for a standard buprenorphine (Suboxone) initiation in the emergency department (ED).
Part of ED toolkit for OUD
Version date: 7 February 2024
A short guide to high-dose buprenorphine (Suboxone) initiation (macrodosing) in the emergency department.
Part of ED toolkit for OUD
Version date: 7 February 2024
A decision-making tool for high-dose buprenorphine (Suboxone) initiation (macrodosing) in the emergency department.
Part of ED toolkit for OUD
Version date: 7 February 2024
A guide for emergency department (ED) clinicians about initiating buprenorphine (Suboxone) in the ED.
Part of ED toolkit for OUD
Version date: 7 February 2024
Responses to some frequently asked questions about initiating buprenorphine (Suboxone) in the emergency department (ED).
Part of ED toolkit for OUD
Version date: 7 February 2024
A short guide for community providers on prescribing buprenorphine (Suboxone) to patients with opioid use disorder (OUD).
Part of ED toolkit for OUD
Version date: 7 February 2024
A decision-making tool for initiating methadone in the emergency department.
Part of ED toolkit for OUD
Version date: 7 February 2024
Templates
An order set for emergency department initiation of methadone.
Part of ED toolkit for OUD
Version date: 7 February 2024
A template for an outpatient methadone prescription after emergency department discharge.
Part of ED toolkit for OUD
Version date: 7 February 2024
A checklist for emergency department (ED) clinicians when asking a patient about their substance use.
Part of ED toolkit for OUD
Version date: 12 January 2022
An order set for emergency department (ED) buprenorphine (Suboxone) initiation, both standard and macrodosing.
Part of ED toolkit for OUD
Version date: 7 February 2024
The Clinical Opioid Withdrawal Scale (COWS) is a validated scale for measuring opioid withdrawal severity.
Part of ED toolkit for OUD
Part of RAAM clinic toolkit
Version date: 19 September 2022
A template for an outpatient prescription for buprenorphine (Suboxone) after initiation in the emergency department (ED).
Part of ED toolkit for OUD
Version date: 7 February 2024
A prescription template for home initiation of buprenorphine (Suboxone) after emergency department (ED) discharge.
Part of ED toolkit for OUD
Version date: 7 February 2024
A prescription template for home microdosing initiation of buprenorphine (Suboxone) after emergency department (ED) discharge.
Part of ED toolkit for OUD
Version date: 7 February 2024
A RAAM clinic referral template for patients being discharged from the emergency department (ED).
Part of ED toolkit for OUD
Version date: 7 February 2024
Administrative resources
A sample application form to add buprenorphine (Suboxone) to the emergency department (ED) formulary.
Part of ED toolkit for OUD
Version date: 7 February 2024
Sample policies and procedures for providing take-home naloxone kits to emergency department (ED) patients who are at risk of opioid overdose.
Part of ED toolkit for OUD
Version date: 1 April 2021
A sample medical directive authorizing emergency department (ED) staff to provide take-home naloxone to patients at risk of opioid overdose.
Part of ED toolkit for OUD
Version date: 1 April 2021
Part of ED toolkit for OUD
Version date: 1 April 2021
Information for emergency department (ED) staff on how language, behaviour, and attitudes can convey stigma towards people who use drugs.
Part of ED toolkit for OUD
Version date: 1 April 2021
Patient materials
A patient handout about buprenorphine (Suboxone) treatment.
Part of ED toolkit for OUD
Version date: 7 February 2024
A patient handout about microdosing buprenorphine (Suboxone) initiation.
Part of ED toolkit for OUD
Version date: 7 February 2024
A patient handout for starting buprenorphine (Suboxone) at home.
Part of ED toolkit for OUD
Version date: 7 February 2024
Instructions on naloxone use for printing and inserting in take-home naloxone kits. Created by CATIE.
Part of ED toolkit for OUD
Version date: 1 April 2022
Jennifer Wyman MD FCFP DABAM MPH
Larry Nijmeh MD CCFP (EM) FCFP
Elizabeth Shouldice MD MPH CCFP (EM) FCFP
Ruben Hummelen MD CCFP
Meldon Kahan MD CCFP FRCPC
Michelle Klaiman MD FRCPC DABAM
Helen Manohararaj MScN NP-PHC ENC (C)
Lisa Roth MD CCFP
Amit Shah MD CCFP (EM) FCFP
Anita Srivastava MD MSc CCFP
James Brokenshire MD CCFP (EM)
Calvin Chan MD CCFP
Katie Dunham BSc Hons BScN MN NP-PHC
Jonathan Gravel MD CCFP (EM)
Nour Khatib MD CCFP (EM)
Kate Lazier MD CCFP (EM) FCFP
James McGorman MD CCFP (EM)
Hasan Sheikh MD CCFP (EM)
Max Zworth MD PGY-1 (EM)